TY - JOUR
T1 - Predictors of poor response to methotrexate in polyarticular-course juvenile idiopathic arthritis
T2 - Analysis of the PRINTO methotrexate trial
AU - Vilca, Iris
AU - Munitis, Pablo Garcia
AU - Pistorio, Angela
AU - Ravelli, Angelo
AU - Buoncompagni, Antonella
AU - Bica, Blanca
AU - Campos, Lucia
AU - Häfner, Renate
AU - Hofer, Michael
AU - Ozen, Seza
AU - Huemer, Christian
AU - Bae, Sang Cheol
AU - Sztajnbok, Flavio
AU - Arguedas, Olga
AU - Foeldvari, Ivan
AU - Huppertz, Hans Iko
AU - Gamir, Maria Luz
AU - Magnusson, Bo
AU - Dressler, Frank
AU - Uziel, Yosef
AU - Van Rossum, Marion A.J.
AU - Hollingworth, Peter
AU - Cawkwell, Gail
AU - Martini, Alberto
AU - Ruperto, Nicolino
PY - 2010/8
Y1 - 2010/8
N2 - Objectives: To determine whether baseline demographic, clinical, articular and laboratory variables predict methotrexate (MTX) poor response in polyarticular-course juvenile idiopathic arthritis. Methods: Patients newly treated for 6 months with MTX enrolled in the Paediatric Rheumatology International Trials Organization (PRINTO) MTX trial. Bivariate and logistic regression analyses were used to identify baseline predictors of poor response according to the American College of Rheumatology pediatric (ACR-ped) 30 and 70 criteria. Results: In all, 405/563 (71.9%) of patients were women; median age at onset and disease duration were 4.3 and 1.4 years, respectively, with anti-nuclear antibody (ANA) detected in 259/537 (48.2%) patients. With multivariate logistic regression analysis, the most important determinants of ACR-ped 70 non-responders were: disease duration >1.3 years (OR 1.93), ANA negativity (OR 1.77), Childhood Health Assessment Questionnaire (CHAQ) disability index>1.125 (OR 1.65) and the presence of right and left wrist activity (OR 1.55). Predictors of ACR-ped 30 non-responders were: ANA negativity (OR 1.92), CHAQ disability index>1.14 (OR 2.18) and a parent's evaluation of child's overall well-being ≤4.69 (OR 2.2). Conclusion: The subgroup of patients with longer disease duration, ANA negativity, higher disability and presence of wrist activity were significantly associated with a poorer response to a 6-month MTX course.
AB - Objectives: To determine whether baseline demographic, clinical, articular and laboratory variables predict methotrexate (MTX) poor response in polyarticular-course juvenile idiopathic arthritis. Methods: Patients newly treated for 6 months with MTX enrolled in the Paediatric Rheumatology International Trials Organization (PRINTO) MTX trial. Bivariate and logistic regression analyses were used to identify baseline predictors of poor response according to the American College of Rheumatology pediatric (ACR-ped) 30 and 70 criteria. Results: In all, 405/563 (71.9%) of patients were women; median age at onset and disease duration were 4.3 and 1.4 years, respectively, with anti-nuclear antibody (ANA) detected in 259/537 (48.2%) patients. With multivariate logistic regression analysis, the most important determinants of ACR-ped 70 non-responders were: disease duration >1.3 years (OR 1.93), ANA negativity (OR 1.77), Childhood Health Assessment Questionnaire (CHAQ) disability index>1.125 (OR 1.65) and the presence of right and left wrist activity (OR 1.55). Predictors of ACR-ped 30 non-responders were: ANA negativity (OR 1.92), CHAQ disability index>1.14 (OR 2.18) and a parent's evaluation of child's overall well-being ≤4.69 (OR 2.2). Conclusion: The subgroup of patients with longer disease duration, ANA negativity, higher disability and presence of wrist activity were significantly associated with a poorer response to a 6-month MTX course.
UR - http://www.scopus.com/inward/record.url?scp=77955450480&partnerID=8YFLogxK
U2 - 10.1136/ard.2009.120840
DO - 10.1136/ard.2009.120840
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C2 - 20525842
AN - SCOPUS:77955450480
VL - 69
SP - 1479
EP - 1483
JO - Annals of the Rheumatic Diseases
JF - Annals of the Rheumatic Diseases
SN - 0003-4967
IS - 8
ER -